"The shorter, the better": a review of the evidence for a shorter contraception hormone-free interval

Graziottin A. "The shorter, the better": a review of the evidence for a shorter contraception hormone-free interval
European Journal of Contraception and Reproductive Health Care. 2015 Aug 20:1-13. [Epub ahead of print]

Menstruation may be considered the genital sign of a local and systemic inflammatory event, characterised by an increase in mast cell degranulation and production of inflammatory molecules including cytokines.Combined oral contraceptives (COCs) traditionally feature a seven-day hormone free interval (HFI), during which menstruation occurs. Formulations with a shorter HFI (24/4 and 26/2) have recently been developed with the aim of offering a reduction in hormone withdrawal-associated symptoms together with more powerful ovarian suppression.E2V/DNG is administered on a 26/2 regimen and has been shown to offer high contraceptive efficacy together with a reduction in heavy menstrual bleeding, improvement in hormone withdrawal-associated symptoms (including but not limited to headache and pelvic pain) and improvement in sexual function.E2V/DNG may therefore be a good alternative to conventional 21/7 COCs for women with bothersome COC- or menstruation-related symptoms. Healthcare professionals should discuss these symptoms in women of reproductive age and raise awareness that treatment is available.

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